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Vax Vex 2: Excelsior!

I’d noted in Vax Vex 1 that Operation Warp Speed’s remarkable success in delivering three viable vaccines to America would put us on the cusp of ending the COVID pandemic, but would give rise to new challenges. High among them is the inevitable bifurcation between the vaccinated and the unvaccinated.

This issue has two phases, with Phase 1 being all those willing to get inoculated, but are awaiting their turn as supplies ramp up. Fortunately, this phase has an expiration date, measured in months. It’s highly likely that by the end of this summer, everyone in America who wants to be stuck, will be.

The more persistent problem will be Phase 2: those unwilling to get inoculated. A significant portion of the population will never receive a COVID injection. As I noted, there are multiple motivations for the unvaccinated, ranging from the contrarian libertarian to the Whole Foods acolyte to the skeptical person of color.

Both of these phases are driving the intense debate over lockdown liberation. Many argue that we must differentiate between the vaccinated and the unclean…er, unvaccinated. This line of thinking argues that access to all public and private venues (save essential services) should require proof of inoculation. Partially, this is intended as a risk-reducing measure – making sure that new outbreaks do not arise among the unvaccinated as we resume whatever passes for normalcy in 2021.

But mostly, the “papers please” pundits see proof of vaccination as leverage, providing an inducement to the unvaccinated to get their shots and rejoin polite society. Peer pressure will be applied to the antivaxxers - in the form of envy as their medicated neighbors resume the freedoms previously canceled by the coronavirus.

New York State got the ball rolling with the Excelsior program, partnering with IBM to establish an electronic passport that permits access to stadiums, concerts, and other large gatherings. Governor Cuomo – seeking to change the subject for some odd reason – touts Excelsior:

The question of ‘public health or the economy’ has always been a false choice — the answer must be both. As more New Yorkers get vaccinated each day and as key public health metrics continue to regularly reach their lowest rates in months, the first-in-the-nation Excelsior Pass heralds the next step in our thoughtful, science-based reopening.

While it’s refreshing to see Governor Cuomo embracing science instead of women, the Excelsior program and its proposed peers gives rise to some new questions, such as:

Q1: When will we no longer need a vaccine passport?

Unlike smallpox, COVID-19 will never be eradicated – it will always be with us. Given the remarkable success of the vaccinations against the emerging variants, future treatments for COVID will likely resemble the seasonal flu, with updated inoculations on a periodic basis. Does this mean that we will require a COVID passport indefinitely? Based on what data and science?

Q2: Which services or facilities will require a COVID passport, and who decides?

Will all businesses and venues that serve the public be mandated to screen for a COVID passport? Or will there be some threshold of risk that triggers a requirement? Will private enterprise make the call, or will it be governmental direction? And if so, which government – federal, state, local? Political pressures have already shaped lockdown rules to favor the connected (see California), so why not COVID passports?

Q3: Who keeps the medical data?

Will it be IBM and their tech giant peers, or will the government control the intel? If the former, how will we be sure the data will not be monetized for financial gains, or weaponized for political ones? If the latter, can we be sure the government(s) will never likewise abuse such sensitive information? Or compromise it via negligence, as has happened many times before?

Q4: Will the passports be limited to COVID?

If yes, why? COVID is merely one among dozens of deadly communicable illnesses. Influenza alone kills tens of thousands every year – why not require a passport for those vaccines as well? What makes COVID unique?

Answers to these questions are not remotely close to consensus; in many cases the questions aren’t being asked in the first place.

And absent such clarity, there’s no way to answer the most important question of all: what is the limiting principal of the COVID passport, the boundary outside of which our rights will remain inviolate?

As if the above weren’t problematic enough, there’s also the white elephant in the room: the disproportionate impact on people of color. Advocates of COVID passports envision a carrot/stick strategy to induce the reluctant rednecks to get their shots, but it’s already clear that minorities will not obtain vaccinations at the same rate as white people. Whether by well-earned skepticism or simple lack of access (medical and electronic), a COVID passport system will negatively impact people of color. Imagine the consequences for a business that finds itself turning away black Americans at a higher rate than whites. Modern anti-racism teaches that any such disparity would be proof of bigotry – the ensuing lawsuits and boycotts (and riots) would quickly shut the business down. How do we prevent COVID passports from becoming a medical apartheid?

Critics of COVID passport systems note the potential for totalitarian abuse, a la China's social credit system already under construction by Silicon Valley. That may be a stretch for now, but advocates of Excelsior and its brethren need to explain how that couldn’t happen here - before I sign myself up to be a human bar code.


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